| NPI | 1558846345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601008625) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 2416) |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2022-10-06 |